Hou Gang, Wang Wei, Zhao Ya-Bin, Su Xin-Ming, Wang Qiu-Yue, Li Zhen-Hua, Kang Jian
The Institute of Respiratory Diseases, The First Affiliated Hospital of China Medical University, China.
Intern Med. 2013;52(11):1211-5. doi: 10.2169/internalmedicine.52.9507.
Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. Pleural effusion is rare in patients with sarcoidosis, occurring in 0.7% to 20% of cumulative series. Bloody pleural effusion is even more rare. We herein report two cases of sarcoidosis with bloody pleural effusion and discuss the clinical manifestations, diagnostic procedures and treatment of these cases. Sarcoidosis should be included in the differential diagnosis when bloody pleural effusions are detected. An increased level of lymphocytes and an increased ratio of CD4+/CD8+ lymphocytes in bronchoalveolar lavage fluid (BALF) are helpful for making a diagnosis of sarcoidosis. Medical thoracoscopy is helpful for determining the definitive diagnosis. Corticosteroids are an effective treatment; however, the dose should be individualized according to the treatment response.
结节病是一种病因不明的多系统肉芽肿性疾病。结节病患者出现胸腔积液的情况较为罕见，在累积病例系列中发生率为0.7%至20%。血性胸腔积液更为罕见。我们在此报告两例伴有血性胸腔积液的结节病病例，并讨论这些病例的临床表现、诊断方法及治疗。当检测到血性胸腔积液时，应将结节病纳入鉴别诊断。支气管肺泡灌洗术（BALF）中淋巴细胞水平升高及CD4+/CD8+淋巴细胞比例升高有助于结节病的诊断。内科胸腔镜检查有助于明确诊断。皮质类固醇是一种有效的治疗方法；然而，剂量应根据治疗反应个体化。
